NPI | 1639434749 |
---|---|
Former Name | DEBBIE LYNN DARIUS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: FL DN19841) |
Additional Taxonomies | 122300000X Dentist (Licence: MA DL13650) |
122300000X Dentist (Licence: FL DN19841) | |
122300000X Dentist (Licence: FL 19841) | |
Enumeration Date | 2012-07-05 |
Last Update Date | 2024-07-15 |